He is smart enough to recognize how awful he is, and dumb enough to be unable to do anything about it.
Slight change: he's smart enough to recognize how awful his life is -- not he, Lucas, personally -- but is either too dumb or too incapacitated by his untreated schizophrenia to do anything about it. Here's something
I said back in October (and there's been no improvement at all since then): "It's rather sad how after living in that flophouse room for however long now, it doesn't look like Lucas has done a single thing to make it more "home-like," or at least less ugly and gloomy. Nothing on the walls except dirt spots. He spent a small fortune buying board games he will never even get to play, but never thought to buy so much as a colorful dollar-store plastic box to hold (and hide) the roll of toilet paper he keeps in his room...."
If Lucas would make SOME effort -- enough to take his meds and visit therapists regularly (and by American standards, he is IMMENSELY lucky to have either opportunity in the first place) -- he could make a life that is not great by modern American or first world standards, but still better than what the majority of people alive today have: he has a private room that is warm in winter and dry when it rains, has 24/7 electricity and running water, access to an indoor toilet and bathing facility (even if he does have to share them), easy access to a coin-operated laundry/clothes-washing facility, and is equipped with a full-size fridge/freezer and oven/stove combo, plus a sink. He has an EBT card to cover his food costs, some sort of health coverage (we've seen him with prescription medications before), and a couple hundred dollars in spending money every month, and he presumably has a bus pass he uses to get around the city.
Most Kiwis, I wager, could make this work if you absolutely had to (assuming or pretending you are single, with no dependent children or other family responsibilities). It would be a huge step down from your current living situation, but within two days of getting your first month's cash spending allowance, you'd have that room (and yourself and your clothes) in far better condition than Lucas ever did, especially if you have no job and no other demands upon your time.
But Lucas either can't or won't make even the minimal effort required to make his room something other than a depressing shithole. Not even as much as a wall calendar with a different attractive picture every month, or a couple of fridge magnets, only piles of board games he never plays, and that printed deer sheet he uses as a window curtain. Even messy young children, or teenage slobs, who never clean their rooms will still do something to decorate them. There are even species of birds that are attracted to shiny or colorful things and will take them to decorate their nests. And animals that gather things like dry leaves and grasses, to make their dens or nests or burrows more comfortable -- equivalent to a human buying extra pillows or cushions to make their homes more comfortable.
But Lucas has done nothing at all along those lines. Nothing to make his room more comfortable, nothing to decorate it, no personalizing it at all except for those piles of unplayed expensive board games.